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Do Not Suppress Addictive Thoughts!

Recently, a man suffering with alcoholism told me how he approached his problem: when he had thoughts of drinking, he tried to push them out of his mind. This didn't always work of course, and even when it did he regularly drank later. But he was still pleased that he was "putting up a good fight" against his enemy — his terrible drive to drink. He asked me if I agreed with his plan, and whether I thought that his intermittent success was a sign that he was making progress. I was sorry to say I did not. Pushing away thoughts of performing addictive actions is, in fact, a terrible idea. His technique was not just doomed to failure but actually interfered with ever mastering his addiction.

Addictive thoughts are never random, so the moments when they occur provide critical opportunities to learn what drives an addiction. Whatever event, circumstance, interaction, thoughts or feelings that occurred just before the appearance of addictive thoughts will be a clue to the issues for which addiction is a solution. To distract oneself at just that moment is the last thing to do if you hope to gain control of addictive behavior.

Naturally, paying attention to any single episode of thinking about drinking or another addictive act may not be sufficient to see the underlying theme behind all one's addictive acts. But the more occasions spent focusing on the precipitating circumstances behind that first instant of addictive thought, the easier it becomes to solve the mystery.

Focusing on these key moments when addictive thoughts first arise also has an immediate value. Even if the precipitating factors are unclear, just thinking about them at these times creates a helpful separation from the helpless feelings that always precede and precipitate addictive thoughts. After all, to think about oneself is to stand beyond one's inner world and observe it, not be immersed in it. Self-observation is an antidote to feeling helplessly trapped.

Suppressing addictive thoughts is also part of another problem. The man I'm describing tried to squelch his addictive thoughts because he viewed his addiction as an enemy to be stamped out. But seeing addiction as his enemy kept him from seeing it as a part of himself: an attempt to resolve intolerably helplessness feelings by taking an action that would restore an immediate sense of power. Instead of thinking of his drinking, or even his thoughts of drinking, as the enemy, he would have been much better off seeing his addiction as a symptom with an understandable emotional purpose and drive. Instead of looking away from his problem, he could have looked toward it and learned about it.

Working to suppress thoughts involves yet another mistaken notion: the false and destructive idea that addiction can be mastered through willpower. The idea that people can control addictions just by trying hard is a longstanding myth that has led to denigration of people with addictions as "weak" or lacking in "character." Of course, people with addictions have as much willpower as anyone else. Like every other psychological symptom, addiction arises from internal, at least partially unconscious, emotional issues and is an attempt to deal with them. Emotional symptoms (which we all have to one degree or another) are not treatable simply through conscious effort. People with addictions can no more stop their symptomatic behavior through willpower than can people with depression, anxiety or phobias. And beyond the unwarranted criticism directed at people with addictions, those who themselves believe that their addiction can be "defeated" by force of will (for example, suppressing addictive thoughts) are setting themselves up to feel worse about themselves when willpower inevitably fails.

It does take work to deal with addiction, but not the work of pushing away thoughts. It is the work of observing one's complex feelings, motivations and conflicts, especially at the time of first thinking of performing an addictive act. Self-observation is not easy for anyone, and is especially hard if thoughts are quickly followed by strong urges to act. But this is where learning about the underlying issues precipitating addiction pays dividends down the road. Once you have identified the specific emotional factors leading to feeling overwhelmingly helpless — and then to addictive thoughts — it becomes possible to predict in advance when these thoughts will arise. That allows time to find ways to deal with these emotional precipitants before feeling flooded by them, not by crushing your own thoughts, but by understanding them.

While I agree that our automatic thoughts can provide some insight into what drives our behavior, I question the usefulness of using such techniques for determining what drives addictive behavior. By the time someone has a dependence on a substance, the conditions that led to the continued use of a substance are less relevant to the current situation that someone has great difficulty functioning without substance use. Perhaps gaining insight into what led to drinking in the first place may help someone avoid relapse or to support their recovery later in treatment, but it seems that no matter what someone is thinking/feeling/avoiding when addicted to a substance,understanding that in itself will not rid anyone of their dependence.

Dr. Dodes is right about the importance of trying to identify the "helpless feelings that always precede and precipitate addictive thoughts." Those helpless feelings, I believe, are caused by one's self-defeating emotional attachment to inner passivity, a place of identification in the human psyche. Our inner passivity is the defensive enabler of our superego or harsh inner critic, as well as a default position in the psyche.
As well, seeing the addiction as "the enemy" misses the point and creates more inner conflict. Read "The Negative Emotions Behind Addictions."

In think the old saying that you can run, but you can't hide comes into play in addiction.

Addiction as I see it and have experienced it in some ways be it more daily things as playing games, food addiction or workaholism and in the more fatal things as alcholism and drug addiction, the addiction serves as a crutch and as a dependable but questionable friend.

The addiction is sought towards when the demands of the situation are larger than one thinks oneself capable of meeting. For example, you might think that you have three weeks of hard and out trying to meet demands that you are unable to do in a way you want to and so turn to the addiction to give some comfort and have some relatedness and to numb the pain and anxiety a bit.

When you are addicted to something, anything, a behavior or food/drug/alchohol and cannot willingly stop immidiately for some defined period of time, then the drug of choice becomes God. The drug gives you some comfort and nurture and releases some pain and fear for a short time, because you know what the drug is and you like some of it in some way, and it is one way to counter to the immense weight of the perceived future that one thinks oneself somewhat unable to handle. It is a survival mechanism.

People may be more or less aware of this cycle and mechanism, but still do it. After some time, there also becomes a habitual part to it, I think, that it is just what one does without questioning it oneself so much.

To deal well and finally with an addiction, you must find out what you are running from, face and handle it in a more positive and beneficial way than going to the drug of the addiction. You can keep running, but if you have not dealt with what brings up the need for the addiction, then you will turn to your drug in your hide.

Removing an addiction from your live is about steadily and slowly in a 2 steps forward - 1 step backwards way learning to meet the requirements and demands of your life as you want it and then not be inclined to turn to your addiction, because afterall, why would you do that then? You don't need it and it doesn't do anything useful for you. Getting off of an addiction is about learning to handle life without reaching and grabbing for that crutch. It takes time and is hard and is a up-and-down battle. That is why you see so many people trying to get of an addiction relapsing. Even those who finally stop the behavior, have relapsed many times some times. It is because that when the demands seem too high and you think, I can't do this, that old numbing comfort and nurture seem a little too good.

If you learn to be able to do it, then you will not find the drug useful or wanted in your life.

Thank you for this post Dr. Dodes. I regularly encourage my patients to face their cravings when they pop up, even in early recovery. Supressing those thoughts and feelings by use of avoidence is not really any different than using behaviors while in addiction. "I don't like how I'm feeling or the direction my life is going, so I'm going to use to escape those feelings." "I don't like how I'm feeling because I'm cravings, so I'm going to think about something else to escape those feelings." No different. If an addict/alcoholic uses the same coping mechanisms, even in recovery, they will get the same results they got in addiction and in my experience, usually end up using again.

Learning how to sit in and deal with the uncomfortable parts of life is the point of recovery from addiction. Simple abstinance is NOT the point of recovery from addiction in my view. "Just don't use" my be a nice cliche to quote at an AA or NA meeting and serves as a reminder of where recovery starts, but in a theraputic environment it's not an appropriate or professional clinical modality.

The facility I work in has just recently started pushing the Matrix Model materials, which has several good and interesting tools with which to work patients through; however, their presentation of "Thought Stopping Techniques" drive me insane. I refuse to teach my patients "Oh, just think of something else. Picture a big light switch in your head and turn it off whenever using thoughts or cravings hit you." Give me a break!

How about we discuss the fact that you're having using thoughts or cravings because you're engaging in old unhealthy behavior patterns and instead of working on changing those patterns you just lean on the good old stand by of avoidence.

Sorry for the rant, but I really appreciated this post today. It's nice to see someone else talking about actually dealing with clinical issues with patients vs. avoidence techniques or blaming everything connected with chemical dependency on brain chemistry.

Thanks for your comment. I entirely agree that the "thought stopping" idea in the "Matrix Model" is destructive and naive. I wonder if your treatment facility would be open to taking a look at the books I've written, "The Heart of Addiction" and "Breaking Addiction," to see a very different way of treating people suffering with addictions.

Dr. Dodes, could you say more about your concept of where, from within the psyche, those emotions emerge that produce what you call the "helplessness trap"? From your background in psychoanalysis, what inner conflict(s) would you say possibly produces these intense negative feelings of helplessness? Why are these feelings so powerful? Why does it happen that some people, driven by their compulsion, resort to such self-damaging behaviors instead of behaviors that would not be harmful? Perhaps you have answered these questions already and can direct me to that information. Thanks.

Dr Dodes. You are pointing in the right direction but I would like to suggest a subtle but crucial tweak to your ideas. Dealing with addiction by dealing with thoughts is like blaming the increase in umbrella use for the rise in the water table in a storm. In my experience of dealing with addiction, you can go in and tackle thoughts to your heart's content and maybe you will be able to change things, for some people. But there will be those who cannot deal with their thoughts, who have no control over them. Serial sex offenders spring to mind. There is however, an effective way of dealing with this troublesome thought, without changing it, recognising it, or doing anything with it. And that is to recognise the nature of thought itself. The 'fact' that we think. The fact that we are feeling our thinking, from moment to moment to moment. And for addicts, those feelings are strong. We are always, only and ever feeling our thinking. We're not feeling our circumstances. We're not even feeling our thinking about our circumstances. We are feeling our thinking. Period. Now, as an understanding of gravity has led to an understanding of how the universe is put together (on a macro and quantum level), we are starting to understand how the human operating system works. We have a thought, and those thoughts are brought alive to us through our consciousness or awareness. Simply having an understanding that this is how it works is the start to a realisation that no human, no matter how bad the behaviour, is broken. We are all using the system (like gravity) perfectly. It is our misunderstanding of how the system works that is the cause of the problem (it's the alcohol giving me the good feelings). This very subtle, simple but crucial shift is the start of a profound insightful journey into recovery. And I can give you plenty of examples of this happening right now. Please do feel free to get in touch if you want to know more. Kind regards, Damian Mark Smyth